Sodium-nitroprusside-induced cyanide toxicity in pediatric patients

Abstract

Background: Sodium nitroprusside (SNP) is often used as a continuous infusion intravenous vasodilator in pediatric patients. However, cyanide toxicity can occur with SNP therapy. Scant literature is available determining the safety of SNP therapy, the incidence of cyanide toxicity or the risk factors for cyanide toxicity in pediatric patients.

Objective: To review the literature concerning the safety of intravenous SNP with regard to cyanide toxicity in the pediatric patient population.

Methods: A MedLine search was used to identify articles pertaining to SNP therapy and cyanide toxicity in pediatric patients.

Conclusions: Sodium nitroprusside seems to be safe when used in critically ill pediatric patients. Cyanide toxicity may occur in patients with specific risk factors. Routine monitoring of cyanide levels may not be warranted.